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generic viagra here viagra online sale without prescription here you can buy generic viagra and get bonuses where to buy viagra without prescription best drugstore where you can buy viagra canadian viagra for sale online Formal neurological testing is not needed in the vast majority of patients with ED. Those with a history of CNS problems, peripheral neuropathy, diabetes, or penile sensory deficit would probably benefit from some level of neurological testing. The sensitivity of the skin of the penis to detect vibrational stimuli, ie, biothesiometry, can be used as a simple nerve function office screening test. This involves the use of a small electromagnetic test probe placed on the right and left sides of the shaft and on the glans. The vibrational amplitude is adjusted until the subjective sensory threshold is reached, which is determined by questioning the patient. A series of these tests determines the average vibrational sensory threshold in each location, which are then compared to reference range standards for the patient's age group. Although this test does not directly measure the erectile nerves, it serves as a reasonable screening for possible sensory deficit and is simple to perform. Formal nerve conduction studies, such as bulbocavernosus reflex latency time, are reserved for very select situations. Explore alternative techniques to receive sexual pleasure. Penile erection is mainly mediated by the parasympathetic nervous system, which when stimulated causes arterial dilation and relaxation of the cavernosal smooth muscle. The increased blood flow into the corpora cavernosa in association with reduced venous outflow results in penile rigidity.

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